Linking Physician Health and Physician Leadership

Faculty: Gigi OslerNothing to declare

The physician health landscape in Canada

Prevalence of + psychological factors

Prevalence of - psychological factors

Polling question: The impact of stigma

Leadership is critical for better physician health

Strategy #2:

“Harness the Power of Leadership”

Canada’s physician workforce

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2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018

Female Physicians in Canada 2000-2018

All Physicians GP/FP All Specialists

Top factors affecting women’s health & wellness

Other factors to watch

Key take-aways• High levels of burnout, despite high levels of resiliency

• Suggests issues is broader than individual factors and extends to other, systemic factors

• Occupational factors were stronger predictors of physician health

• Relatively few differences across demographics• Suggests health and wellness issues relevant to physicians across the profession

• Stigma is a barrier to seeking help • Suggests stigma needs to be addressed and eliminated to normalize help-seeking

Faculty: Rollie NicholRelationships with financial sponsors:

Grants/Research Support: NilSpeakers Bureau/Honoraria: NilConsulting Fees: NilPatents: NilOther: Employee of Alberta Health Services

Disclosure of Financial SupportThis program has received financial support from CCPH in the form of subsidized travel and accommodation

Potential for conflict(s) of interest:Currently, President Canadian Society of Physician Leaders

Part 2 – Leader’s Intent1. Good will and good intent2. Sensitivity to impact3. Boundaries between individual wellness and the

collective4. What’s a leader to do?5. How can we simplify it?

A leader’s intent plus development of a collective will supported by accountability – that creates our new reality – our future

Tale of 3 Physician Leaders1. Context2. Intent of new Department Head3. Legacy of the previous Department Head4. Where is the Hospital Lead?5. What went wrong?6. Where are we now?

Faculty: Mamta GautamRelationships with financial sponsors:

Grants/Research Support: NilSpeakers Bureau/Honoraria: NilConsulting Fees: NilPatents: NilOther: CEO, PEAK MD Inc

Disclosure of Financial SupportThis program has received financial support from CCPH in the form of subsidized travel and accommodation

Potential for conflict(s) of interest:Board member, Canadian Society of Physician Leaders

Part 3 – Impact of Leadership on Health1. The Link:

• Are Physician Health and Physician Leadership linked? • If so, how?

2. Physician Engagement: • How can we better engage our physician colleagues?

3. Compassionate Leadership: • How can we be more compassionate as leaders?

Preventing Burnout

We need to stop blaming doctors and see this as a shared responsibility of:

•Individual physicians•Culture of medicine•Healthcare systems

Quit Multiplying By Zero (Gautam, CJPL 5(3), 2019))

Engagement is the Opposite of Burnout

1. Executive Leadership and Physician Well-being, Shanafelt and Noseworthy, Mayo Clin Proc, January 2017:92(1): 129-146

2. Utrecht Work Engagement Scale (UWES) (Schaufeli and Bakker, 2003)

Successful leaders have mastered physician engagement.1. Leading leaders2. Being right is not enough

Factors Influencing Physician Engagement• degree of physicians' trust in leadership• involvement in clinical and administrative policy decision-making• reactions to various changes in the healthcare industry — such

as technology• authority over their own schedules • the amount of support available to them• their personal health and well-being

What might we do as leaders that could improve physician engagement?

The 3 A’s of Successful Leadership1. Availability2. Affability3. Ability

3 Factors that lead to motivation1. Autonomy - the desire to direct our own lives2. Mastery - the urge to get better and better at something that

matters3. Purpose - the yearning to do what we do in the service of

something larger than ourselves.

Drive, Daniel H. Pink, 2009

Herzberg’s Two-Factor TheoryTwo types of factors in the workplace:

1. Motivators: cause job satisfaction (achievement, recognition, responsibility, advancement, nature of the work)2. Demotivators or Hygiene Factors: a separate set of factors that can cause dissatisfaction (salary, administration, supervision, company policy, status, working conditions)

We need to address both.

Boston Consulting Group‘Simply showing the data helps lead to the solution’

Show people the problem; there is no need to tell them the solution. They will come up with the solution on their own and be more engaged.

Buy-In vs Ownership

Spurgeon’s Medical Engagement Model

Medical Engagement Model Developing a medical engagement scale (MES) , Spurgeon P et al,The International Journal of Clinical Leadership 2008;16:213–23

Leadership missteps directly affect physician engagement and wellbeing• Administration may not listen to their opinions or suggestions, or

ask for physicians' input after they have already made a decision• A lack of understanding among leaders about what physicians

want or the stress they might feel, which leads leaders to make decisions that impact physicians without understanding the context of a situation.

Acknowledge and Assess BurnoutOpen candid conversations to acknowledgeMeasure physician well-being as a routine performance metricIdentify leaders to foster wellness and engagement, address issues of concernCultivate sense of community at workPromote flexibility and work-life integrationProvide resources to promote resilience

Compassionate LeadershipCollective compassionate leadership enables health care innovation: • Intrinsic motivator of staff • Promotes a culture of learning • Creates cultural safety • Recognizes and supports organizational failures (suffering) which are a prerequisite to innovation

West M et al. The King’s Fund. Caring To Change: How compassionate leadership can stimulate innovation in health care

Compassion is a four part process:

1. Noticing that suffering is present 2. Interpreting and making meaning of suffering in a way that contributes to a

desire to alleviate the suffering 3. Feeling empathetic concern for the person or people suffering 4. Acting to alleviate suffering in some manner

Worline & Dutton. Awakening Compassion at Work: The Quiet Power That Elevates People and Organization. 2017

Leading with Compassion• We look to leaders for guidance, particularly in times of suffering.• Compassion deeply bonds us with others and is central to human well-being,

both for those who provide it as well as for those who receive it.• Compassion is more than an emotion; it is a felt and enacted desire to

alleviate suffering.• Leaders can guide other team members about how to think, feel and act

when suffering surfaces by how they act or role model. • Leaders can use their position and power to shift the architecture of an

organization, and direct resources to alleviate suffering.- Worline & Dutton

Linking Physician Health and Physician Leadership